Burntwood Lodge

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

The provider did not always ensure people's care and treatment were planned and delivered following a comprehensive assessment of their needs. Whilst care plans contained information about people's support requirements, there was limited evidence that people's wellbeing and communication needs had been consistently explored, reviewed and discussed with them as part of the assessment process. This placed people at risk of receiving care that was not always fully tailored to their individual circumstances and preferences.

The provider’s had a system for care records and monitoring documentation throughout the service. While records were generally available, the system was not always easy to navigate, particularly when reviewing historical information or locating key care and support documents. This increased the risk that important information may not be readily accessible to staff and made effective oversight and monitoring more challenging.

However, staff were generally knowledgeable about people's diagnosed health conditions and the support they required. Care records contained information about people's health needs, which provided staff with guidance on how to support them on a day-to-day basis.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

We found gaps in staff knowledge which reduced assurance that care was consistently delivered in line with current best practice. Staff demonstrated a limited understanding of the principles of RSRCRC and that staff had received training in this area. As a result, the provider could not demonstrate that staff fully understood how to apply these principles to promote person-centred care, independence, choice, inclusion and positive outcomes for people with a learning disability.

However, the provider used recognised assessment tools to support the delivery of care and treatment. For example, Malnutrition Universal Screening Tool (MUST) assessments had been completed and were used to identify and monitor risks associated with nutrition and hydration. One member of staff said, “We have the MUST and we weight them and check their skin to see if there are any issues.” Where people were identified as being at risk, appropriate information was recorded to support staff in providing care. Skin integrity assessments were also completed, which helped identify people at risk of skin breakdown and informed preventative care measures.
 

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

The provider did not have an effective system for multidisciplinary working and information sharing to support positive outcomes for people. We found the provider did not always share comprehensive assessments of people's needs when people moved between services. Records did not always evidence that information regarding people's health, care, wellbeing, communication and support needs was shared with others. This reduced assurance that transitions were planned and coordinated effectively.

However, staff worked together to meet people's day-to-day needs and there was evidence that people were supported to access healthcare services when required. For example, people were supported to attend health appointments and had hospital passports in place to help healthcare professionals understand their individual needs, preferences and communication requirements. Staff were knowledgeable about the people they supported and worked together to provide continuity of care. One member of staff told us, “We are a very small team, and we get along very well.”

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Leaders did not always promote healthy lifestyles through the food provided. Meals available within the service were not always nutritious or balanced, and the provider could not consistently demonstrate that people were supported to make informed choices about healthy eating. This reduced assurance that people's nutritional wellbeing was being actively promoted. Records showed that the person had experienced significant weight gain and was now within the obese range; however, there was insufficient evidence to demonstrate that their weight was being routinely monitored, assessed, or appropriately addressed to identify and manage any associated health risks.

However, people were supported to access healthcare services and attend health appointments when required. One relative told us, “They take her medical appointments if she’s got any problems. They are on top of things.” Records demonstrated that referrals were made to healthcare professionals and people attended routine and specialist appointments to help monitor and maintain their health. Staff understood the importance of seeking medical advice when concerns about a person's health arose. One health professional told us, “Burntwood Lodge refer to our team regularly and always in a timely manner.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and
consistent, or that they met both clinical expectations and the expectations of people themselves.

The provider did not always have effective systems in place to monitor outcomes for people and identify when additional support or intervention was required. Whilst care records contained some information about people's health needs, monitoring arrangements were not consistently robust for people including those at risk of urinary tract infections and constipation.

However, there were some systems in place to monitor people's health outcomes and identify when additional support was required. For example, people with epilepsy had seizure monitoring records in place and information was available to guide staff on how to support them safely. Records demonstrated that seizures were documented and healthcare advice was sought when required. One health professional told us, “Burntwood Lodge have a consistent care team and understand the needs of the person on our pathway. They have spotted physical health decline in the past and this has led to a good outcome for the person.”

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

We identified gaps in the assessment of capacity for some significant healthcare decisions. Records did not consistently demonstrate that leaders had ensured capacity assessments had been completed by professionals where people had undergone dental treatment under general anaesthetic or other invasive hospital procedures. In these circumstances, the provider could not demonstrate how it had established whether people had the capacity to consent to the proposed treatment, or if decisions had been made in their best interests where they lacked capacity.

However, the registered manager had undertaken mental capacity assessments for a number of other decisions and there was evidence that staff considered people's ability to make specific decisions about their care and support. This demonstrated an awareness of the principles of the Mental Capacity Act 2005 and the importance of supporting people to make their own decisions wherever possible.